When we talk about hormone methods of birth control we are primarily referring to a pill form of contraception that contains hormones. Oral contraception can be convenient and reliable when used properly. Approved more than 45 years ago, it continues to be one of the most popular forms of birth control. More than 18 million women depend on “the pill” and there are more than 40 different oral contraceptives. Nowadays, the new low dose (meaning lower doses of hormone) pills have less health risks and even some possible health benefits. Birth control pills contain synthetic forms of progesterone alone or combined with estrogen, and they prevent ovulation (egg release) by keeping your body’s hormones from fluctuating. If you are over 35, smoke, have a history of blood clots or breast or endometrial cancer, you may not be a good candidate for oral contraception. You do need a prescription for birth control pills and they are typically set up in a 28 day cycle pack with 3 weeks of actual hormone containing pills and 7 days of blanks (non-hormone containing pills).
Progestin only pills (mini pills) are a good choice for breastfeeding women (who don’t want estrogen in the pill to impact their milk supply) and for women who cannot take estrogen. They must be taken the same time everyday, may be slightly less effective than the combination pills and side effects may include irregular bleeding/spotting, headaches, abdominal pain.
Combination pills contain estrogen and progesterone in varying amounts. They are typically set up as 21 hormone containing pills and 7 blanks to mimic a 28 day cycle, though multi-phasic pills have varying amounts of the hormones in the 21 out of 28 day’s worth of pills. There is also now a continuous pill (Lybrel) that prevents menstruation entirely by offering hormones in the entire month’s supply. These combination pills offer some benefits including:
- Lowered rates of ovarian and endometrial cancers
- Lowered risk of ectopic (outside the uterus) pregnancies, if a pregnancy does occur
- Less PMS
- More regular menstrual cycles
- Acne improvement
- Possible improvement of your cholesterol profile
- Easily reversible with quick return to fertility
Disadvantages include possible increased risk of hypertension, nausea and vomiting in first few cycles of use, breast tenderness/increased size, weight gain, irregular bleeding. Since oral contraception can interact with certain medications you do need to review your current medications with the prescribing doctor.
Some things to consider:
- You can also decide to take your regular birth control pill, skip the blanks, and avoid menstruating entirely, though this works best when the pill has the same amount of hormone in the 21 day’s of active pills. You may have increased breakthrough bleeding.
- It can take up to six months for fertility to return to a normal baseline state, after stopping oral contraception.
- If you miss a dose of birth control you should consult with your doctor and use a back up barrier method of birth control.
- The risk of hypertension increases in women as they age and with duration of use.
- If you are over 35, you may be at increased risk of heart disease with birth control pills.
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